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Which is included in Healthy People 2020 objectives?
- A. To decrease the incidence of mental illness
- B. To increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives
- C. To provide mental health services only in the community
- D. To decrease the numbers of people who are being treated for mental illness
Correct Answer: B
Rationale: One of the Healthy People 2020 objectives is to increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives. It may not be possible to decrease the incidence of mental illness or to provide services only in the community.
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Which of the following is a standard of practice?
- A. Quality of care
- B. Outcome identification
- C. Collegiality
- D. Performance appraisal
Correct Answer: B
Rationale: Standards of practice include assessment, diagnosis, outcomes identification, planning, implementation, coordination of care, health teaching and health promotion, and milieu therapy. The standards of professional performance include quality of practice, education, professional practice evaluation, collegiality, collaboration, ethics, research, resource utilization, and leadership.
Which is a positive aspect of treating clients with mental illness in a community-based care?
- A. You will not be allowed to go out with your friends while in the program.
- B. You will have to have supervision when you want to go anywhere else in the community.
- C. You will be able to live in your own home while you still see a therapist regularly.
- D. You will have someone in your home at all times to ask questions if you have any concerns.
Correct Answer: C
Rationale: Clients can remain in their communities, maintain contact with family and friends, and enjoy personal freedom that is not possible in an institution. Full-time home care is not included in community-based programs.
The legislation enacted in 1963 was largely responsible for which of the following shifts in care for the mentally ill?
- A. The widespread use of community-based services
- B. The advancement in pharmacotherapies
- C. Improved rights for clients in long-term institutional care
Correct Answer: A
Rationale: The Community Mental Health Centers Construction Act of 1963 accomplished the release of individuals from long-term stays in state institutions, the decrease in admissions to hospitals, and the development of community-based services as an alternative to hospital care.
What is meant by the term revolving door effect in mental health care?
- A. An overall reduction in incidence of severe mental illness
- B. Shorter and more frequent hospital stays for persons with severe and persistent mental illness
- C. Flexible treatment settings for mentally ill
- D. Most effective and least expensive treatment settings
Correct Answer: B
Rationale: The revolving door effect refers to shorter, but more frequent, hospital stays. Clients are quickly discharged into the community where services are not adequate; without adequate community services, clients become acutely ill and require rehospitalization.
A student appears very nervous on the first day of clinical in a psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions?
- A. Tells the client about personal events and interests
- B. Discusses the anxious feelings with the instructor
- C. Assumes that the client's unwillingness to talk to a student nurse is a personal insult or failure
- D. Builds rapport with the patient before asking personal questions
- E. Consults the instructor if a shocking situation arises
- F. Gravitates to clients that the student may know personally
Correct Answer: B,D,E
Rationale: Listening carefully, showing genuine interest, and caring about the client are extremely important rather than speaking about oneself. The student must deal with his or her own anxiety about approaching a stranger to talk about very sensitive and personal issues. Student nurses should not see the client's unwillingness to talkಸ�ದtalk to a student nurse as a personal insult or behavior. Being available and willing to listen are often all it takes to begin a significant interaction with someone. Questions involving personal matters should not be the first thing a student says to the client. These issues usually arise after some trust and rapport have been established. The nursing instructor and staff are always available to assist if the client is shocking or distressing to the student. If the student recognizes someone he or she knows, it is usually best for the student to talk with the client and reassure him or her about confidentiality.